Malignancy in multinodular goiter: analysis of trends

Abstract

Objective: To know the incidence of malignancy in multinodular goiter and analyze trends of its occurrence with respect to age and gender Study Design: Descriptive cross-sectional study Place and duration of study: Surgical Ward 25 of Endocrine and General surgery, Jinnah Postgraduate Medical Center, Karachi. Th is study carried out from 1st September 2017 to 30th March 2019. Material and Methods: 122-patients with simple multinodular goiter were included in this study. Patients with toxic multinodular goiter (MNG), thyroid malignancy, recurrent thyroid disease and MNG below 12 years of age were excluded from this study. All patients who met study criteria underwent total thyroidectomy. Results are described as frequency, percentages and mean. Results: 122-patients of multinodular goiter underwent total thyroidectomy, out of which 101 (82.78%) were benign and 21 (17.2%) were found to be malignant. Out of the 21 malignant biopsies, 17 (13.9%) were papillary thyroid cancer and 4 (3.27%) were follicular thyroid cancer. Of the 122 patients operated upon, 18 (14.75%) were below 30 years, 81 (66.39%) were between 30 to 50 years and 22 (18%) patients were above 50 years of age. MNG remained common in women as of the 122 patients 102 (83.6%) cases were female and 20 (16.39%) were male. Conclusion: Multinodular goiter remains common in middle age females but malignancy was found to be more common in male multinodular goiter (7 out of 20 MNGs). Th e female to male ratio of MNG was found to be 5.1:1 whereas for malignancy this ratio was 2:1. Papillary cancer of thyroid was more common than the follicular variety. Th us, the authors conclude that MNG carries a risk of malignancy which should not be under-valued, and should be included in surveillance program.